What is considered "excessive" urination/thirst?

[allebu]

I brought my son in to the pediatrician today because he's had several instances of wetting through his diapers and pants. This has been going on for a couple of weeks now. He has food allergies so he drinks soy milk. He is supposed to get no more than 24 oz. of soy milk per day and he drinks that before noon. He never has a dry diaper and when I change him after about 3 hours it's so heavy it's falling off. I'd say his diaper is dry for about 15 minutes, max.

My question is, how much urination is considered "excessive" for a 14 month old? How much fluid intake is considered excessive?

His ped gave us a urine collection bag and told us to use it in the morning after we change his night diaper and then dip a dipstick in to see if it changes color. What does that mean if it does?

He has no other symptoms (i.e. no weight loss, no fatigue, etc.) but the ped says that those symptoms are for advanced diabetes and that if it's not advanced he won't appear sick.

I'd love some input from you guys! Thanks so much!

-Alle

[Caynuns mom]

Did your peditrician test your childs blood sugar level when you were there today? It seems as though if your ped is saying that your child is having experiencing symptoms of diabetes then a blood glucose test would have been protocol. And when your ped said to dip the stick in the urine did they give any instructions on what you were to do regarding color changes?

These are red flag symptoms of diabetes
Excessive thirst
Excessive urination
weight loss

Make sure to watch for these signs of DKA (diabetic ketoacidosis). shows of any of these symptoms go to the ER:
Vomiting
Sweet (fruity) odor to breath
Dry Mouth
Drowsiness
Deep Breathing

If you know of anyone who has diabetes use their meter to test your child with.

[yeswe'rebothD]

Alle--
If the dipstick changes color, it could be one of two things-- the sticks will test for sugar or ketones in the urine. Either one of these appearing on the dipstick would likely mean that your ds is showing a strong possibility of having diabetes.

The other symptoms may be advanced for some. They were very subtle for us. Our dd sleeps very heavily anyway, and was still taking 2-3 hour naps when she was dxd. She was 5. She also had been a very chubby baby, so I didn't think ANYthing of it that she didn't gain any weight between ages 2 and 5-- she weighed 35lb those 3 years. Now looking back, I realize that for her frame, she should have been gaining at least before/around 5 years.

Other things you can look for that may not be obvious symptoms:

dry or itchy skin
dry mouth
fruity or acetone (like nail polish remover) smelling breath
stomachache
cuts/bruises slow to heal
frequent infections
blurry vision

I would especially take note of the breath-- if it smells fruity, I'd take your ds to the ER. A child developing diabetes can get very sick, very quickly.

What did they tell you to do if the dipstick shows color?

~Iana

[allebu]

Nope, they didn't do a blood glucose test. I think the ped's thinking that it's a possibility but not likely? He didn't say that, but I would have thought they could have done a quick finger prick test, no? I was a little surprised.

They said if the dipstick changes color to call the office. My question is, there's a broad range of colors that it can change, from green to brown. If it changes even the slightest bit, is that normal or is that an indication that, regardless of the small change, he has glucose or ketones in his urine?

[Caynuns mom]

Nope, they didn't do a blood glucose test. I think the ped's thinking that it's a possibility but not likely? He didn't say that, but I would have thought they could have done a quick finger prick test, no? I was a little surprised.

I'm very surprised they didnt do a quick finger prick! It seems as though alot of us heard the "not likely" words.
It may not be Diabetes BUT if it is Diabetesplaying the waiting game around a ped who isnt making sure right from the start can be dangerous.

[yeswe'rebothD]

Alle-- those colors sound like they're the type that tests sugar in the urine. I'm not familiar with the colors, so I'm not of much help there. What I do know is that any sugar spilling over in the urine is not normal.

I found this on Yahoo!:

http://health.yahoo.com/topic/diabetes/resources/article/healthwise/aa115833

It says toward the bottom, that for sugar to show up in the urine, the blood sugar has to be at least 180, which is a high number for someone who isn't diabetic.

HTH, sorry if I duplicate what someone else posts (while I'm taking forever typing and googling!)

[Danda]

At BG>200 the glucose will show up in his urine. The dipstick will change color and depending on the color, the dr will know if he is having high blood glucose(BG). After night, normal level of BG will be under 120. The dr will also look for ketone in urine, which if they are moderate to large could mean DKA - diabetic ketoacidosis- which in small children is very dangerous. At diagnoses my DD was DKA. They put her in ped ICU for 48 hours with insulin drip.

Here you will find an explanation for the dipstick analysis. Almost in the middle of the page you will find the color chart. The first row is for control(anything on your stick matching first row is safe). The further right your stick mach, the biggest the problem.

http://www.medicine.uiowa.edu/cme/clia/modules.asp?testID=19
http://www.baptistonline.org/health/library/test5239.asp

Wetting diapers and pants in 3 hours I will consider excessive.

[allebu]

He does have very dry skin, but he's had eczema since birth. Cutting out his allergens has drastically improved but he definitely has very dry skin besides that.

It is excruciating to wait an entire day to test his urine!

[Abby-Dabby-Doo]

Allebu-
Hang in there. The only advice I can pass on to you is from another post...

You can go to your pharmacy and ask for Ketodiastix (NOT more than $10 at Target-where I live). They are little sticks that test for sugar and ketones in the urine (both of which may be present with a person who has diabetes). If they don't have ketodistix ask for ketostix. Put a cotton ball in your sons diaper and after he has urinated you can squeeze the urine from the ball and dip the stick into the urine. Follow the directions in the packaging for measuring ketone and glucose levels. If anything is out of the normal range, I would immediately call your Dr. to report the readings and tell them that you would like to speak with a Dr. immediately or you will be headed to the ER with your son.

Please know I'm thinking of you and hoping for the best!

[Amy C.]

Allebu-
Hang in there. The only advice I can pass on to you is from another post...

You can go to your pharmacy and ask for Ketodiastix (NOT more than $10 at Target-where I live). They are little sticks that test for sugar and ketones in the urine (both of which may be present with a person who has diabetes). If they don't have ketodistix ask for ketostix. Put a cotton ball in your sons diaper and after he has urinated you can squeeze the urine from the ball and dip the stick into the urine. Follow the directions in the packaging for measuring ketone and glucose levels. If anything is out of the normal range, I would immediately call your Dr. to report the readings and tell them that you would like to speak with a Dr. immediately or you will be headed to the ER with your son.

Please know I'm thinking of you and hoping for the best!

If you purchase ketone sticks and test for ketones as described above and your child has ketones, this is really serious. Your child's life is in danger if he has ketones and you wait before going to the ER.

[Mojo's mommy]

Why do you have to wait until the morning? If it were me I would be doing it now,surely they gave you more than 1 dipstick? Do 1 now and 1 in the morning

[allebu]

That was great advice! I put the cotton ball in his diaper and in about 10 minutes had enough to use with a dipstick that the doctor gave me. It didn't turn color at all!

Does that mean we're definitely out of the woods, or should I also retest in the morning?

And absolutely, if I got an abnormal test, I'd call the doc immediately!

[Mama Belle]

Alle-

I can't really add any practical advice beyond what folks have already given you.

I will say that what you describe sounds like excessive urination and thirst to me. If there is a possibility that this is emerging diabetes, it should be taken very seriously, as kids can go from showing minimal symptoms (excessive/frequent urination & thirst) to being very sick in a small amount of time.

Best of luck!

[jpb286]

That was great advice! I put the cotton ball in his diaper and in about 10 minutes had enough to use with a dipstick that the doctor gave me. It didn't turn color at all!

Does that mean we're definitely out of the woods, or should I also retest in the morning?

And absolutely, if I got an abnormal test, I'd call the doc immediately!

I would buy my own Ketodiastix (ketone+glucose urine strips).

Who KNOWS how old the doctors strips are or if they have been exposed to light or moisture, etc... there are too many unknowns. If I were you, I would purchase a blood glucose meter.

Most pharmacies ALWAYS have SOME promotion going on, and MOST meters include 10 test strips with the meter itself. Walmart had the OneTouch Ultra-Mini for less than 20 bucks today. A small price for peace of mind.

[deafmack]

Whoa! What century is this doctor living in? A single finger prick blood sugar test would have answered the question without you having to go through all the urine collecting. This would be a good question to ask your doctor. You sure would have had your question answered sooner.

[Ellen]

I brought my son in to the pediatrician today because he's had several instances of wetting through his diapers and pants. This has been going on for a couple of weeks now. He has food allergies so he drinks soy milk. He is supposed to get no more than 24 oz. of soy milk per day and he drinks that before noon. He never has a dry diaper and when I change him after about 3 hours it's so heavy it's falling off. I'd say his diaper is dry for about 15 minutes, max.

-Alle

This is NOT normal, whether or not it's type 1 diabetes. The pediatrician needs to figure out why your child is urinating so excessively. Ask about diabetes insipidus (http://www.nlm.nih.gov/medlineplus/ency/article/000377.htm) too.

My then 15 month old toddler presented with the same situation with diapers so heavy they felt as if he had been in a swimming pool. each time. He ultimately did present with lethargy, weight loss, etc. I urge you to go back to the pediatrician and ask for more tests to be run immediately. Blood tests need to be run. Watch your child's weight very carefully...any presentation of 10% weight loss, loose clothing, lethargy, dark circles under the eyes, labored breathing, vomiting would indicate it's a life threatening emergency and with type 1 diabetes in an infant or toddler, it can happen very fast. Urine testing is antiquated. Every person has a different threshold for spilling sugar in urine. Urine ketone testing is also only indicative of what was happening in the blood several hours earlier.

Trust your instincts as a mother - if it doesn't seem right, it's NOT. You know it. Good luck and good health to your child.